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Percutaneous Zadek Osteotomy for Insertional Achilles Tendinopathy
Tyler A Gonzalez1, Sarah Hall Kiriluk2, Oliver N Schipper3
1Department of Orthopaedic Surgery, University of South Carolina, Prisma Health - Midlands, Colombia, SC, USA.
Foot and Ankle Clinics
|July 31, 2026
Summary
The percutaneous Zadek osteotomy (ZO) offers a safe alternative for insertional Achilles tendinopathy. This minimally invasive approach leads to fewer complications and a faster recovery compared to traditional open surgery.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Sports Medicine
Background:
- Open midline Achilles tendon splitting is the traditional treatment for insertional Achilles tendinopathy and Haglund's deformity.
- This open hindfoot procedure, while effective, is linked to significant complications and prolonged recovery periods.
Purpose of the Study:
- To evaluate the safety and efficacy of the percutaneous Zadek osteotomy (ZO) for treating insertional Achilles tendinopathy.
- To compare the outcomes of ZO with the traditional open surgical approach.
Main Methods:
- Retrospective or prospective study design comparing percutaneous Zadek osteotomy (ZO) with open Achilles tendon splitting.
- Assessment of complication rates, healing, and return to function post-surgery.
Main Results:
- The percutaneous Zadek osteotomy (ZO) demonstrated a high safety profile with minimal complications.
- Patients undergoing ZO experienced effective healing and a notably earlier return to function and activity.
Conclusions:
- Percutaneous Zadek osteotomy (ZO) is a safe and effective alternative for insertional Achilles tendinopathy.
- ZO offers advantages over open surgery, including reduced complications and faster patient recovery.
